Ferritin modifies the relationship between inflammation and arterial stiffness in hypertensive patients with different glucose tolerance

Abstract

Background: Ferritin, a crucial element for iron homeostasis, is associated with chronic diseases characterized by subclinical inflammation such as essential arterial hypertension and type 2 diabetes mellitus (T2DM), showing a prognostic value in different clinical settings. We investigated whether ferritin is associated with arterial stiffness (AS), an early indicator of atherosclerosis, and if it could act as effect modifier on the relationship between inflammation and AS in hypertensive patients with different glucose tolerance. Methods: We enrolled 462 newly diagnosed untreated hypertensive (HT) patients. All subjects underwent an oral glucose tolerance test. Insulin sensitivity was assessed by MATSUDA index and ferritin levels were estimated by immunoradiometric assay. AS was defined by carotid-femoral pulse wave velocity (PWV). Results: Out of 462 patients, 271 showed normal glucose tolerance (HT/NGT), 146 impaired glucose tolerance (HT/ IGT) and 45 were diabetic (HT/T2DM). Iron levels significantly decreased and transferrin and ferritin significantly increased from the first to the third group. PWV values were significantly higher in HT/IGT and HT/T2DM patients. PWV was related directly with ferritin, high sensitivity C reactive protein (hs-CRP), transferrin, and inversely with MATSUDA index. Ferritin resulted the strongest determinant of PWV explaining a 14.9% of its variation; moreover it was a strong modifier of the relationship between hs-CRP and PWV. The estimated augmentation in PWV portended by a fixed increase in hs-CRP, was higher across increasing values of ferritin. Conclusion: Ferritin represents an independent risk factor of arterial stiffness in our study population and a strong effect modifier on the relationship between inflammation and PWV. However, further studies are needed to fully elucidate the potential role of this biomarker in human atherosclerosis.

Arterial Stiffness Assessment by Pulse Wave Velocity in Patients with Metabolic Syndrome and Its Components: Is It a Useful Tool in Clinical Practice?

“…As shown in a study performed by Gong et al, AS became significant with increasing numbers of the metabolic components [ 101 ]. However, multiple regression analysis revealed that not only are MS components responsible for PWV level, but also age, sex, HR, serum uric acid level, and ferritin level were shown to significantly affect the relationship between inflammation and PWV [ 86 , 121 , 122 , 123 ]. Therefore, more studies are required to improve the interpretation of PWV in the treatment of MS patients.…”

Effect of renal denervation on long-term outcomes in patients with resistant hypertension

“…RDN also reduced whole-body norepinephrine spillover [ 49 ], did not significantly change plasma catecholamines [ 46 ], and had a mixed influence on aldosterone [ 45 , 47 , 48 , 50 ]. In addition, arterial stiffness is a leading biomarker of risk in hypertension [ 51 ], and ferritin represents an independent risk factor of arterial stiffness [ 52 ]. However, the close relationship between ferritin and RH still needs further study.…”

The Effects of RBP4 and Vitamin D on the Proliferation and Migration of Vascular Smooth Muscle Cells via the JAK2/STAT3 Signaling Pathway

“…Diabetic macroangiopathy, a specific form of atherosclerosis secondary to diabetes, causes cerebro-cardiovascular diseases, which are correlated with high mortality and morbidity in diabetic patients. Previous studies have shown that subclinical inflammation and insulin resistance play significant roles in the development of atherosclerosis and diabetes mellitus (DM) [ 1 , 2 ]. In addition, the role of adipocytokines in the pathological physiology of diabetic macroangiopathy has attracted considerable attention of the scientific community in recent years.…”